Autism reconsidered

Wired covers the beginning of a possible revolution in how we understand autism from both a humanistic and a scientific point of view.

The article starts by discussing Amanda Baggs who is a non-speaking but incredibly articulate young woman with autism.

We discussed her video previously on Mind Hacks which remains a remarkably inspiring challenge to how we understand and value people who experience the world differently.

This alternative view of autism as a variation rather than a disorder in human neurology has been taken up by some researchers, and the article also looks at how recent neuropsychology research is starting to reframe the condition.

The first test, known as the Wechsler Intelligence Scale, has helped solidify the notion of peaks of ability amid otherwise pervasive mental retardation among autistics. The other test is Raven’s Progressive Matrices, which requires neither a race against the clock nor a proctor breathing down your neck. The Raven is considered as reliable as the Wechsler, but the Wechsler is far more commonly used…

What the researchers found was that while non-autistic subjects scored just about the same ‚Äî a little above average ‚Äî on both tests, the autistic group scored much better on the Raven. Two individuals’ scores swung from the mentally retarded range to the 94th percentile. More significantly, the subset of autistic children in the study scored roughly 30 percentile points higher on the Raven than they did on the more language-dependent Wechsler, pulling all but a couple of them out of the range for mental retardation.

While the majority of autism research is very much disorder based, the article is a wide-ranging look at the autism spectrum and a great review of some of the new thinking that beginning to challenge the status quo.

Link to article ‘Scientists Reconsider What They Think They Know’.

Fragments of consciousness

Dana’s online neuroscience magazine Cerebrum has a fantastic article on trauma and dissociation – the splitting of consciousness that apparently makes some aspects of the mind inaccessible to others.

Dissociation is a term that’s used rather loosely in modern psychology and psychiatry. It is sometimes used to be synonymous with derealisation or depersonalisation, describing a feeling of being detached from reality or not being ‘grounded’ in your usual sense of self.

However, in its original and most interesting formulation by the French psychiatrist Pierre Janet, it describes the splitting of consciousness so one part of conscious experience is compartmentalised, becomes inaccessible, is literally ‘dis-associated’ from the rest.

Its not clear why it occurs, but Janet’s theory (often erroneously ascribed to Freud) suggests its a defence against psychological distress. Like the mental equivalent of brushing something under the carpet until you’re unaware it existed or you even did the brushing.

Regardless of whether it is genuinely a ‘defence’ in this sense, it is thought to be at play in conversion disorder, where a person might experience paralysis despite having no damage to the muscles or nervous system (so called ‘hysterical paralysis’).

There is now growing evidence that the high level control systems in the brain deliberately inhibit the movement in the immobile limb, outside the conscious control of the patient.

It is also thought to be the mechanism by which hypnosis has its effect on those susceptible to it. In this case, however, it is a form voluntary dissociation guided by suggestion – meaning someone can have the experience of, for example, limb movement without the associated sense of having willed the action.

One of the most striking demonstrations of this form of dissociation is where some people can be hypnotised not to be bothered by pain, despite the fact they can report on its intensity – even to the point of surgical operations being possible without anaesthetic in some rare cases.

Perhaps it’s not surprising then that dissociative disorders, where patients are seemingly permanently dissociated from their memory (dissociative amnesia) or dissociated from their senses or actions (conversion disorder) are particularly linked to trauma.

The most controversial of these syndromes is what used to be called ‘multiple personality disorder’, but is now called ‘dissociative identity disorder’ to suggest that the patient’s very personality structure has become dissociated from itself, seemingly leading to several identities or ‘alters’.

It’s partly controversial because it was so obviously over-diagnosed in a period of 1950s and 60s American psychiatry that was seemingly drunk on Freudian theory without recourse to the strong coffee of scientific testing.

But its also controversial because its so rare despite still being in the diagnostic manuals. For example, I’ve never met a patient with the condition, and I’ve never met anyone who’s met a patient with the condition, whereas I’ve seen many patients with dissociative amnesias and conversion disorders.

The Cerebrum opens as if it’s about ‘multiple personality disorder’ but don’t be fooled – it’s actually a really good review of what cognitive science has told us about how trauma might cause dissociation (almost all the research mentioned is on memory rather than ‘multiple personalities’).

This is still a controversial area but the article gives the case for the link. The article presents evidence that experience of childhood abuse, both physical and sexual, may be particularly linked to dissociation, perhaps suggesting that it arises from an attempt at a ‘defence’ in some cases.

Cognitive scientists are now increasingly interested in dissociation and hopefully this new level of interest should unlock some of the its mysterious secrets.

Link to article ‘Coming Apart: Trauma and the Fragmentation of the Self’.

2008-02-29 Spike activity

Quick links from the past week in mind and brain news:

“Chewing gum and context-dependent memory: the independent roles of chewing gum and mint flavour”: A lovely forthcoming paper from The British Journal of Psychology. has a video debate on natural *cough*, sorry, experimental philosophy.

Pure Pedantry investigates the neurological basis of the “runner’s high“.

Have you been in psychotherapy doctor? The New York Times has an article on the dying tradition of psychiatrists being in therapy.

A new book on ‘neuroarthistory‘ is picked up by My Mind on Books.

Bolding going back to 1962. The Sunday Herald reports on a recently discovered neuroreceptor link found between psychosis and effects of LSD.

Parapsychologist Dean Radin is interviewed by the San Francisco Chronicle.

We respond differently to babies’ faces within 150 milliseconds. Cognitive Daily covers a MEG study of face recognition responses in the brain.

BBC News reports that poor diet is linked to bad behaviour in children.

To the bunkers! $24 billion spend predicted to developed autonomous robot armies. You have 20 seconds to comply!

The first human nerve tissue transplant has been completed. Next step, Robocop (we hope).

Wired reports on a psychologist leading the competition to develop a film recommendation algorithm and win the Netflix Prize.

How do psychologists study what we know about ourselves? Psychologist Virgina Kwan writes a guest article for the BPS Research Digest

Against compulsory happiness: The LA Times discusses the miracle of melancholia and BBC News asks is depression good for you?

First Monday ponders whether whether the increasingly media obsessed world needs to be understood as an attention economy.

Deric Bownd’s has a primer on executive function in the prefrontal cortex.

The normality of strangers

The only normal people are the one’s you don’t know very well.”

A quote from the Austrian psychologist Alfred Adler. Not sure exactly where this quote comes from, but it’s widely quoted on the net.

Adler was hugely influential in the early Freudian circle and coined the term ‘inferiority complex’ to describe what he thought was the innate sense of inferiority we are all born with and need to learn to manage as part of our development.

He believed that this developmental process shaped the personality and was reflected in each person’s individual personality traits.

UPDATE: I’ve just noticed that there don’t seem to be any photographs of Alfred Adler Smiling. Cheer up Dr Adler.

Medicated Americans

Scientific American Mind has a fantastic article on the endemic use of antidepressant drugs in the United States. It starts with some surprising statistics: 11 percent of American women and 5 percent of men are on antidepressants.

Serious clinical depression is devastating, and if ever you needed convincing that mental illness should be taken as seriously as physical illness, you only need to meet someone suffering in the depths of a mood disorder.

In contrast, the article notes that the modern concept of depression and the diagnostic criteria have been increasingly widened to cover states of low mood or disinterest that would previously have never been thought of as a medical problem.

It’s full of interesting snippets from the scientific literature to suggest the pervasive influence of this new broader ‘depression’ on society.

For example, a 2007 study found that 1 in 4 people treated for depression have recently experienced a major emotional setback, such as a marriage break-up, a job loss or a financial crisis – suggesting the emotional difficulties may be part of a normal reaction to a serious life event.

A 2006 study found that three-quarters of people prescribed antidepressants receive them for a non-licensed or ‘off label’ reason – for a purpose that there is no strong evidence for.


If statistics serve, we know a number of things about the Medicated American. We know there is a very good chance she has no psychiatric diagnosis. A study of antidepressant use in private health insurance plans by the New England Research Institute found that 43 percent of those who had been prescribed antidepressants had no psychiatric diagnosis or any mental health care beyond the prescription of the drug. We know she is probably female: twice as many psychiatric drugs are prescribed for women than for men, reported a 1991 study in the British Journal of Psychiatry. Remarkably, in 2002 more than one in three doctor’s office visits by women involved the prescription of an antidepressant, either for the writing of a new prescription or for the maintenance of an existing one, according to the ­Centers for Disease Control and Prevention.

This is not to dismiss the suffering of those who have less disabling mood problems – each of which can be a torment in itself.

The key question though, is should it be the responsibility of medicine to prevent these unpleasant mood states, and if so, is medication the answer?

Psychological therapies are known to be effective treatments when depression first occurs and better than drugs in preventing relapse, and for much mild – moderate depression increasing activity levels and light exercise can be strikingly effective.

For more serious cases, a combination of drugs and psychological treatment is the most effective treatment.

The boundaries of illness say as much about our society as they do about our medical advances because it is impossible to define illness without making a value judgement about what point normal variation becomes a pathology.

Depression and antidepressants and complicated because there are many interests – individual, professional, scientific and financial – all shaping how we detect and treat ‘it’.

Over these last few months it has become clear that medication is not as effective as the published evidence has led us to believe, and that we need to radically rethink how we understand mood problems and help those who suffer them.

While the SciAm article focuses on the US where the problem is most apparent, it is clear that this is an issue facing many countries in the West.

Link to SciAm article ‘The Medicated Americans’.